Business Income Tax Release for February

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990-T

Department of the Treasury
Internal Revenue Service (77)

| | Checkbox if
address changed
Exempt under section
Xj501( c )(3 )

“ 408(e) □ 220(e) Type 12021 N. 12TH STREET IE

_ 408A [J 530(a) Cl1y w ,own sla,e aP a * le

1529(a) IGRAND JUNCTION CO 81501-2980

enSof'ytar ** 3 " < ” sels 01 F Group exemption number (See instructions for Block F.). *~

32,550,173. G Check organization type .. . * xTsOI(c) corporation I [501(c) trust ~ 401 (a

Describe the organization's primary unrelated business activity.

COLLECTION AGENCY

During the tax year, was the corporation a subsidiary in an affiliated group or a parent-subsidiary controlled group?
If 'Yes,' enter the name and identifying number of the parent corporation . *

Exempt Organization Business Income Tax Return

(and proxy tax under section 6033(e))

For calendar year 2007 or other tax year beginnin g May 1 , 2007, .

and ending Apr 30 . 2008 _ (7/9 /

*• See separate instructions. [J O '

Name of organizatoM | | Check box it name changed ana see instructions.)

>rint COLORADO WEST HEALTHCARE SYSTEM DBA COMMONITY HOSPITAL
or TJujeberT street, and room tv suits mender. rf a P. O box, see instructions.

ype 2021 N. 12TH STREET

OMB No. 1565-0687

1007;

Esqi (c)(3) Orga nigoo a * j)nl y^j

Employer identification number
(Em p Joyces’ bust, see
instructions for Block D )

84-0469270

Slate

ZIP code

codes (See in
Block t )

CO

81501-2980

561490

►

501(c) trust

401 (a) trust

Other trust

J The books are in care of*~ THE HOSPITAL

RartllJll Unrelated Trade or Business income

1 a Gross receipts or sales . .

b Less returns and allowances . . . c Balance

2 Cost of goods sold (Schedule A, line 7)i

3 Gross profit. Subtract line 2 from line 1c.

4a Capital gain net income (attach Schedule D)

b Net gain (loss) (Form 4797, Part II, line 17) (attach Form 4797)

c Capital loss deduction for trusts

5 Income (loss) from partnerships and S corporations

(attach statement)

Rent income (Schedule C)

sC Unrelated debt-financed income (Schedule E)

'S’ Interest, annuities, royalties, and rents from controlled

organizations (Schedule F)

(TRi Investment income of a section 501(cX7), (9), or (17) organization (Sch G) . .
Exploited exempt activity income (Schedule I) .

(A) Income

Telephone number*’ (970) 256-6320.
I (B) Expenses _l— (C)Net

Advertising income (Schedule J) .

Other income (See instructions; attach schedule.)

Total. Combine lines 3 through 12

158,922.

| Deductions Not Taken Elsewhere (See instructions for limitations on deductions.)

(Except for contributions, deductions must be directly connected with the unrelated business income.)

14 Compensation of officers, directors, and trustees (Schedule K) . . 14

15 Salaries and wages 15

16 Repairs and maintenance 16

17 Bad debts 17

18 Interest (attach schedule) 18

19 Taxes and licenses 19

20 Charitable contributions (See instructions for limitation rules.) 20

21 Depreciation (attach Form 4562) _21 JBI

22 Less depreciation claimed on Schedule A and elsewhere on return 22al 22 1

23 Depletion

24 Contributions to deferred compensation plans

25 Employee benefit programs

26 Excess exempt expenses (Schedule I)

27 Excess readership costs (Schedule J)

28 Other deductions (attach schedule)

29 Total deductions. Add lines 14 through 28

30 Unrelated business taxable income before net operating loss deduction. Subtract line 29 from line 13.

31 Net operating loss deduction (limited to the amount on line 30)

32 Unrelated business taxable income before specific deduction. Subtract line 31 from line 30

33 Specific deduction (Generally $1 ,000, but see line 33 instructions for exceptions)

34 Unrelated business taxable income. Subtract line 33 from line 32. If line 33 is greater than line 32, ent

the smaller of zero or line 32

BAA For Privacy Act and Paperwork Reduction Act Notice, see Instructions. TEEA0201 07/26/0;

TEEA0201 07/26/07

7.312.

7,312.

151, 610 ■

151,610.

1 , poo-

iso, 610.

Form 990-T (2007)

D-

I

Form 990- T (20019 Colorado vest Healthcare system dba commpmity hospital

Schedule C — Rent Income (From Real Prope

84-0469270

see instructions

T Description ot property

2 Renf received or accrued 1

(a) From personal property
(if the percentage of rent for personal
property is more than 10% but
not more than 50%)

(b) From real and personal property
(if the percentage of rent for
personal property exceeds 50% or
if the rent is based on profit or income)

3 Deductions directly connected
with the income in columns 2(a) and 2(b)
(attach schedule)

Total income. Add totals of columns 2(a) and 2(b) Enter
here and on pagel, Part I. line 6, column (A)

Schedule E - Unrelated Debt-Financed Income (see instructions

1 Description of debt-financed property

2 Gross income from
or allocable to
debt-financed property

Total deductions. Enter
here and on page 1 , Part
I, line 6, column (B) . . . ►

3 Deductions directly connected with or allocable to
debt-financed property I

(a) Straight line
depreciation (attach sch)

(b) Other deductions
(attach schedule)

Enter here and on page 1 , Enter here and on page 1 ,
Part I, line 7, column (A). Part I, line 7, column (B)

Totals . . . ►(

Total dlvidends-recelved deductionsincluded in column 8

Schedule F — Interest Annuities, Royalties, and Rents from Controlled Organizations (see instructions'

Exempt Controlled Organizations

1 Name of Controlled
Organization

2 Employer
Identification
Number

3 Net unrelated
income (loss)
(see instructions)

4 Total of specified
payments made

5 Part of column 4
that is included
in the controlling
organization’s
gross income

6 Deductions directly
connected with income
in column 5

7 Taxable Income 8Net unrelated 9 Total of specified 10 Part of column 9 that is 11 Deductions directly

income (loss) payments made included in the controlling connected with income

(see instructions) organization’s gross income in column 10

Add columns 5 and 10 Enter Add columns 6 and 1 1 . Enter
here and on page 1, Part I, line here and on page 1, part I, line
8, column (A) 8. column (B).

Totals

BAA

TEEA0203 07/26/07

Form 990- T (2007)

COLORADO WEST HEALTHCARE SYSTEM DBA COMMUNITY HOSPITAL 84-04 69270

Part JIM Tax Computation

35 Organizations Taxable as CorporationsSee instructions for tax computation.

° > Controlled group members (sections 1561 and 1563) check here *■ [x] . See instructions and:
a Enter your share of the $50:000, $25,000, and $ 9,925,000 taxable income brackets (in that order):

0) 1$ 50,000- 1 (2) |$ 25,000. 1 (3) 1$ 9,925,000- 1

b Enter organization's share of.fl) Additional 5% tax (not more than $1 1 ,750) . . $

(2) Additional 3% tax (not more than $100,000) $

c Income tax on the amount on line 34 ^

36 Trusts Taxable at Trust Rates.See instructions for tax computation. Income tax on the amount

, on line 34 from: Q Tax rate schedule or Q Schedule O (Form 1041)

37 Proxy tax. See instructions

38 Alternative minimum tax

39 Total. Add lines 37 and 38 to line 35c or 36, whichever applies

Tax and Payments

40a Foreign tax credit (corporations attach Form 11)8; trusts attach Form 1116). . 40a __

b Other credits (see instructions) 40b ___

c General business credit. Check here and indicate which forms are attached;

I I Form 3800 Q Form(s) (specify) ► 40 c

d Credit for prior year minimum tax (attach Form 8801 or 8827) . . 40 d

e Total credits. Add lines 40a through 40d

41 Subtract line 40e from line 39

42 Other taxes. Check if from: Q Form 4255 Q Form 861 1 Q Form 8697 Q Form 8866

I 1 Other (attach schedule)

43 Total tax. Add lines 41 and 42 .... .. .

44 a Payments: A 2006 overpayment credited to 2007 44a 23, 781 ■

b 2007 estimated tax payments 44b 20, 339 ■

c Tax deposited with Form 8868 44c 36, 000 .

d Foreign organizations- Tax paid or withheld at source (see instructions) . . 44 d

e Backup withholding (see instructions) 44 e

f Other credits and payments: _ Form 2439

[~1 Form 4136 - _ Other Total. ► 44 g ___

45 Total payments. Add lines 44a through 44f

46 Estimated tax penalty (see instructions). Check if Form 2220 is attached [x]

47 Tax due. If line 45 is less than the total of lines 43 and 46, enter amount owed

46 Overpayment. If line 45 is larger than the total of lines 43 and 46, enter amount overpaid ►

49 Enter the amount of line 48 you wantiCredited to 2008 estimated tax 39, 4 60 ■ | Refunded *i

44b

20,339.

44c

36,000.

44 d

44 e

_44a

40,643.

Statements Regarding Certain Activities and Other Information (see instructions.

1 At any time during the 2007 calendar year, did the organization have an interest in or a signature or other authority over a

financial account (bank, securities, or other) in a foreign country? If YES, the organization may have to file Form TD F 90-22.1
If YES, enter the name of the foreign country her?"_

2 During the tax year, did the organization receive a distribution from, or was it the grantor of, or transferor to, a foreign trust? .
If YES, see the instructions for other forms the organization may have to file.

3 Enter the amount of tax-exempt interest received or accrued during the tax year ► $

Schedule A — Cost of Goods Sold. Enter method of inventory valuation ►

1 Inventory at beginning of year . _1 6 Inventory at end of year . .

2 Purchases . . _2 7 Cost of goods sold.Subtract

3 Cost of labor 3 line 6 from line 5. Enter here

and in Part I, line 2

4 a Additional section 263A costs (attach schedule)

b Other costs

(attach sch)

5 Total. Add lines 1 through 4b

Do the rules of section 263A (with respect to
property produced or acquired for resale) apply
to tne organization?

B arer’S firm's name (or

yours It self-

SB employed), *

Dnlw address, and

uniy ZIP code

adwick, Steinkirchner, Davis & Co., P.C.

225 North 5th Street, Suite 401

Grand Junction CO 81501-2645

Preparer's SSN or PTIN

P0 0121704

ein 84-0865725

Phone no. (970) 24 5^3000

Form 990-T (2007)

TEEA0202 05/02/07

Form 990-T (2007) Colorado west healthcare system dba community hospital 84-04 69270

Schedule G - Investment Income of a Section 501 (c)(7), (9), or (17) Oraanization (see instructions

1 Description of income

2 Amount of income

3 Deductions
directly connected
(attach schedule)

4 Set-asides
(attach schedule)

5 Total deductions and
set-asides (column 3
plus column 4)

Enter here and on page 1
Part I, line 9, column (A).

Enter here and on page 1 .
Part I, line 9, column (B).

Totals

Schedule I — Exploited Exempt Activity Income, Other Than Advertising Income (see instructions

1 Description of exploited activity

2 Gross
unrelated
business
income
from trade
or business

a 4 Net income

* h S 6S (loss) from
directly unrelated trade

connected or business
with production (column 2 minus
of unrelated column 3). If a

business 9 ain ( compute

inrrtma COlUfTWlS 5

,ncome through 7.

5 Gross income
from activity
that is not
unrelated
business
income

6 Expenses
attributable to
column 5

7 Excess
exempt
expenses
(column 6 minus
column 5,
but not more
than column 4).

Enter here and Enter here and
on page 1 , on page 1,

Part I, line 10, Part 1^ line 10,
column (A) column (B)

Totals : . . ►

Schedule J — Advertising Income (See instructions.

Income From Periodicals Reported on a Consolidated Basis

Enter here and
on page 1 ,
Part II, line 26.

lEEEjllBI

1 Name of periodical

2 Gross
advertising
income

3 Direct
advertising
costs

4 Advertising
gain or (loss)
(column 2 minus
column 3). If a
gain, compute
columns 5
through 7.

5 Circulation
income

6 Readership
costs

7 Excess
readership
costs (column 6
minus column
5, but not
more than
column 4).

Income From Periodicals Reported on a Separate Basis (For each periodical listed in Part n, fill m columns 2
through 7 on a line-by-line basis.)

Enter here and
on page 1 .
Part f line fl ,
column (A).

Enter here and
on page 1,
Part I, line fl,
column (B).

Totals, Part II (lines 1 -5

Schedule K — Compensation of Officers, Directors, and Trustees (see instructions

3 Percent of
time devoted
to business

Enter here and
on page 1 ,
Part II, line 27.

4 Compensation attributable
to unrelated business

Total. Enter here and on page 1, Part II, line 14 .

8AA

TEEA0204 07126/07

Form 990-T (2007)